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Journal Article > Commentary
Campbell D, Dontje K. J Emerg Nurs. 2019;45:149-154.
Handoffs in the emergency department are vulnerable to error. This commentary describes an improvement initiative that focused on structuring nurse shift change using situation, background, assessment, recommendation (SBAR) communication methods. Although safety culture scores improved, the authors note that resistance to change was a key barrier to implementation.
Journal Article > Study
Gazarian PK, Henneman EA, Chandler GE. Clin Nurs Res. 2010;19:21-37.
This qualitative study explored the cues that nurses use to determine when a patient's clinical condition is worsening, with specific attention to factors influencing nurses' decisions to obtain assistance from the rapid response team or call a "code blue." Rather than relying on specific vital sign abnormalities, nurses relied on a combination of clinical findings (such as altered mental status), help from other experienced nurses, and their prior knowledge of the patient's baseline condition to determine when urgent physician assessment was needed. The study reveals the importance of a positive safety culture in ensuring that frontline staff feel empowered to enlist additional help when necessary.
Cases & Commentaries
- Spotlight Case
- Web M&M
Christopher Beach, MD; February 2006
A woman comes to the ED with mental status changes. Although numerous tests are run and she is admitted, a critical test result fails to reach the medicine team in time to save the patient's life.